Agreement Between the State of Montana

AGREEMENT BETWEEN THE STATE OF MONTANA

AND THEinsert TribeFOR

TITLE IV-E CHILD WELFARE SERVICES

AND RELATED INDIAN CHILD WELFARE (ICWA) SERVICES

CONTRACT NUMBER:insert contract number

PREAMBLE

Indian Tribes are sovereign nations and a unique government-to-government relationship exists between theinsert Tribe and the State of Montana. The best interests of the Indian Tribes and the State of Montana will be served by engaging in government-to-government relationships and respectfully recognizing the rights, duties and privileges of both Tribal and State citizenship and by ensuring all Indian children are treated equally with regard to the provision of Title IV-E eligible services. The State of Montana and Indian Tribes working together ingovernment-to-government relationships and engaging in Agreements for the benefit of Indian and non-Indian residents promotes effective Tribal-State relations.

This Agreement demonstrates a commitment by the Parties to implement this government-to-government partnership with respect to the provision of foster care services to eligible Indian children. The Indian Child Welfare Act (ICWA) authorizes States and Indian Tribes to enter into Agreements with each other regarding care and custody of Indian Children (Attachment “A”). Title IV-E of the Social Security Act also authorizes States and Tribes to enter into Title IV-E Agreements for the payment of foster care for children determined to be eligible for Title IV-E funding and for administrative funding associated with staffing and training of staff and foster and adoptive parents. The State-Tribal Cooperative Agreements Act, § 18-11-101 et seq., MCA, promotes cooperation between State agencies and sovereign Tribal governments, and authorizes the State of Montana to enter into this Agreement with theinsert Tribe.

The Parties agree to perform their respective duties and responsibilities under this Agreement in good faith and in a spirit of cooperation to accomplish the purpose of providing foster care services to Title IV-E eligible Indian children residing on the insert name of reservation.

SECTION 1:PARTIES

This Agreement is entered into between the State of Montana, by and through the Montana Department of Public Health and Human Services (hereinafter the "Department"), whose address and phone number are P.O. Box 8005, 301 S. Park, Helena, Montana, 59604, and (406)841-2400, and the insertTribe (hereinafter the "Tribe"), whose insert Federal ID number, mailing address, fax number, and phone number are: insert Federal ID number, mailing address, fax number, and phone number.

As used herein, “Parties” refers to the Tribe and the State.

Specific Tribal and State liaisons and their contact information are identified in Section 20 of this Agreement.

THE PARTIES AGREE AS FOLLOWS:

SECTION 2:PURPOSE

The purpose of this Agreement is to set forth the terms, definitions, and conditions by which the Parties intend to perform their respective duties and responsibilities, in good faith and with a genuine spirit of cooperation, in providing lawfully available Title IV-E foster care services to all Title IV-E eligible Indian children as set forth herein.

SECTION 3:TERM OF AGREEMENT

A.The term of this Agreement is frominsert begin datethrough insert end dateunless otherwise terminated in accordance with the provisions of this Agreement. This Agreement may be extended if the Parties agree in writing to the extension prior to the end of the current term of this Agreement.

B.The completion date of performance for purposes of issuance of final payment for services is the date upon which the Tribe submits to the Department such final reports as are required under this Agreement and are satisfactory in form and content as determined by the Department.

C.Each party,after termination of this Agreement, remains subject to and obligated to comply with all legal and continuing contractual obligations arising in relation to its duties and responsibilities that may arise under the Agreement including, but not limited to, record retention, audits, indemnification, insurance, the protection of confidential information, recipient grievances and appeals and property ownership and use.

D. Either party may request a meeting to review and discuss performance of this Agreement.

SECTION 4:SERVICES TO BE PROVIDED

A.The Department agrees to provide:

1Funding in accordance with Attachment B, and G, of this Agreement for Title IV-E eligible administrative functions;

2.Funding in accordance with this Agreement for Title IV-E monthly foster care payments, Title IV-E supplemental support service payments, Title IV-E subsidized relative guardianship payments, and Title IV-E subsidized adoption payments made on behalf of Title IV-E eligible children under Tribal Court jurisdiction who are Montana Title IV-E eligible;

3.Consultation to enhance Tribal compliance with Title IV-E requirements and State policies and procedures which support Title IV-E compliance;

4.Upon request or as mutually agreed upon, technical assistance related to Title IV-E requirements to provide the complete and accurate documentation necessary to determine a child’s Title IV-E eligibility;

5.Determinations of Title IV-E eligibility for foster care payments, financial predetermination for subsidized relative guardianship payments, and subsidized adoption payments for children under Tribal Court jurisdiction in a timely manner. Upon departmental receipt of all required information necessary to determine eligibility, including wage information, the Department shall make every effort to make a determination within one business week;

6.Upon request or as mutually agreed upon, training related to Title IV-E eligibility and Title IV-E foster care services. In addition, the State shall:

● notify the Tribe of annual Child and Family Services Division policy training to enhance compliance with Federal regulations and awareness of State policy; and

● notify the Tribe of all relevant trainings related to Title IV-E.

7.Upon request or as mutually agreed upon, technical assistance to the Tribe in claiming Title IV-E administrative costs;

8.Federal guidance, policy interpretations, information memorandums, and program instructions related to Title IV-E received by the Department from the Administration of Children and Families, Children’s Bureau, or other information affecting or impacting this Agreement;

9.Assistance to the Tribe and to work cooperatively with the Tribe in all areas of Title IV-E compliance;

10.The Department agrees to comply with the Indian Child Welfare Act, Attachment “A” of this Agreement, as defined and interpreted under Federal law and rule.

11. The Department agrees to provide the Tribe with written time study results within 30 days of the annual close out (see Attachment “C”).

B.The Tribe agrees to:

1. Provide Title IV-E foster care services, Title IV-E subsidized relative guardianship services, and Title IV-E adoption services to Title IV-E eligible children in accordance with applicable Federal and State requirements, and in compliance with Attachments “A” through “M”, which are hereby incorporated by this reference into the Agreement; and

1. If the Tribe elects, to initiate discussions with the Department related to the opportunity to enter into a separate contract for Title IV-E reimbursement for attorney fees.

SECTION 5:LICENSURE

A.The Tribe agrees to comply with all Federal requirements related to licensure in Attachment “A” and the licensing requirements described in Attachment “B”.

B.The Department agrees to recognize Tribal licenses issued pursuant to written Tribal licensing standards as described in Attachment “F”.

SECTION 6:CONSIDERATION AND PAYMENTS

A.In consideration of the services to be provided through this Agreement, the Tribe is to receive from the Department reimbursement for services rendered in accordance with those costs provided for in Attachment “C” and as follows:

1. The parties agree that the total amount of State General fund reimbursement from insert begin date through insert end date shall not exceed insert GFO dollar amount. The reimbursement of State Generalfund will be determined in accordance with Attachment “C” by the amount of Title IV-E allowable administrative expenditures the Tribe has incurred and paid during the identified time frame.

The Parties agree that from insert begin date through insert end date the Tribe will have the ability to access Title IV-E funding. The amount of Title IV-E reimbursement the Tribe will receive will be determined by the cost associated with providing Title IV-E allowable services to Title IV-E eligible children. The amount of Title IV-E reimbursement the Tribe receives will be determined in accordance with Attachment “C” by the amount of Title IV-E eligible administrative expenditures the Tribe has incurred and paid during the identified time frame. No reimbursement can be made by the Department to the Tribe until all required Title IV-E financial documentation is received from the Tribe;

2.Following Tribal submission of all required information necessary to determine eligibility and Tribal completion of all required data entry, the Department shall make timely monthly Title IV-E foster care payments to fully licensed out-of-home providers on behalf of Title IV-E eligible children under the jurisdiction of Tribal Court;

3.The Department shall provide State General Fund monies to match Title IV-E funds utilized for foster care, subsidized relative guardianship, and subsidized adoption payments made on behalf of children under Tribal Court jurisdiction who are Montana Title IV-E eligible;

4.Subject to 4(a) and 4(b) of this Section, the Department shall provide State General Fund monies to match Title IV-E funds utilized for the following Title IV-E eligible supplemental support services provided to children under Tribal Court jurisdiction who are Montana Title IV-E eligible: child care, clothing, diapers, and transportation. The Tribe shall provide the Title IV-E supplemental support services in accordance with Attachment “I”.

1. Supplemental support services are dependent upon availability of funding.

1. If funding is not available for supplemental support services, reductions shall be made in the supplemental support services provided to all Title IV-E eligible children under the placement authority of Tribal Social Services and the DPHHS, Child and Family Services Division.

1. Supplemental support services are not available to families for children in a Title IV-E relative guardianship or in a Title IV-E subsidized adoptive placement.

5.The Department may receive adoption incentive payments in accordance

with Section 473 of the Social Security Act [42 U.S.C. 673 (b)]. If the

Department receives adoption incentive funding and if the children

included in the calculation of the amount of adoption incentive funds

received include eligible children under the jurisdiction of Tribal Court the

Department will provide the Tribe with a payment equal to a pro-rated

share of the adoption incentive funding based on the percentage of their

Tribal Court children in the total number of adopted children used in

calculating the amount of adoption incentive funds received.

B. The Tribe agrees to:

1.Provide Tribal IV-E matchable funds, according to Tribal determination in accordance with applicable law, as described in Attachment “C”;

2.Submit actual expenditures for each month of this Agreement on the reimbursement form provided by the Department. The Tribe will submit the monthly expenditure form accompanied by the time sample with all requirements in Attachment “G” by the 10th of each month;

3.Prior to submitting a reimbursement claim under the process described in Attachment “C”, the Tribe must provide the Department with all final billings, time samples/saturation rate information, and other required documentation for the previous year. Billing for subsequent year’s expenses will not be processed until final billing and required documentation for the previous fiscal year have been received by the Department;

4.Submit a reimbursement claim and time sample information within 30 days of the end of the state fiscal year;

5.Assume responsibility for all administrative costs, including indirect costs that are not specifically addressed in Attachment “C” of this Agreement;

C.No payment shall be issued under this Agreement if the Tribe has not submitted the required time sample for the month for which reimbursement has been requested.

D.The consideration provided to the Tribe under this Agreement may be adjusted by the Department in its discretion based on state or federal audit findings (pursuant to Section 12: Repayment of Improper or Erroneous Payments).

SECTION 7: TITLE IV-E ALLOWABLE TRAINING COSTS

A.The Tribe may submit claims for reimbursement of Title IV-E allowable training costs in accordance with Attachment “K” which is incorporated by reference into this Agreement. Title IV-E allowable costs include costs for pre-service training required to become a licensed foster/adoptive parent, ongoing training for foster/adoptive parents, and Title IV-E allowable training to Tribal Social Services staff listed in Attachment “C”.

1. The Tribe does not need to develop a specific training budget or have a training budget line item in Attachment “C” to request Title IV-E training reimbursement.

1. The Department shall disseminate the CFSD Training Calendar to the Tribe and to the extent possible, identify the percentage of the training content which is Title IV-E reimbursable for individual training events.

SECTION 8:BENEFITS RECEIVED ON BEHALF OF THE CHILD

A.Before the Department can make a Title IV-E foster care payment under this Agreement on behalf of a Title IV-E eligible child, the Tribe shall utilize all funding available to the child, including but not limited to Social Security death benefits, Auxiliary benefits from a disabled parent, Railroad or Veteran benefits, and child support payments, to offset the child’s cost of care.

B.If the child is eligible for Supplemental Security Income (SSI), the Tribe may choose to have the Department make a Title IV-E foster care payment on behalf of a Title IV-E eligible child in lieu of SSI. If Title IV-E is used in lieu of SSI, the payee for the child’s SSI must request that the SSI payment be suspended.

SECTION 9:INTERSTATE COMPACT ON THE PLACEMENT OF CHILDREN

A.For the purposes of the Department’s financial contribution for placement of children in out-of-home care under this Agreement, the Tribe agrees to accept children from out-of-state if they are placed according to procedures outlined in the Interstate Compact on the Placement of Children (ICPC), Mont. Code Ann. § 41-4-101 et. seq.

B.The Tribe agrees that, pursuant to the ICPC, the child’s sending State must maintain legal and financial responsibility for the child.

C.The Parties understand and agree that the Tribe is not legally required to enter into the ICPC when accepting out-of-state placements of Indian children onto the Reservation.

D.If the Tribe accepts any child without an approved Interstate Compact agreement in effect under which the sending State retains jurisdiction, the Tribe may not presently claim administrative costs for case management services provided with respect to that child and the Department will not make a Title IV-E foster care payment on behalf of the child. The State and the Tribe agree to amend this provision as soon as is practicable if the Federal government notifies the Department in writing that such costs may be claimed. If such costs become Title IV-E allowable, those costs will be allowable for those children transferred to Tribal Court jurisdiction and placed in out-of-home care by the Tribe after the date of receipt of official notification from the Federal government.

E.The Department agrees to process the Interstate Placement of Children requests received from sending States in a timely manner.

SECTION 10:CREATION AND RETENTION OF RECORDS

A.The Tribe must create and maintain records of the services covered by this Agreement, including financial records, supporting documents and such other records as are required by law or other authority.

B.The Tribe agrees to provide the Department, Legislative Auditor, or their authorized agents, access to any records necessary to determine Agreement compliance.

C.The Tribe and the State agree to retain records for a period of three (3) full Federal Fiscal Years from the completion of the foster care episode, or three (3) full calendar years after the end of this Agreement, whichever period is longer. If any litigation, review, claim or audit is started before the expiration of the three year period, the records must be retained until all litigation, reviews, claims or audit findings involving the records have been resolved.

D.The Tribe must provide the Department and its authorized agents with reasonable access to records the Tribe maintains for purposes of this Agreement. The Tribe must make the records available at all reasonable times at the Tribal Finance Office and Tribal Social Services Office located at insert address.

SECTION 11:ACCOUNTING, COST PRINCIPLES AND AUDIT

A.The Parties, in accordance with 18-4-311, MCA and other authorities, must maintain for the purposes of this Agreement an accounting system of procedures and practices that conforms to Generally Accepted Accounting Principles (GAAP).

B.The Partiesor any other legally authorized governmental entity or their authorized agents may at any time during or after the term of this Agreement conduct, in accordance with 5-13-304 and 18-1-118, MCA and other authorities, audits for the purposes of ensuring the appropriate administration and expenditure of the monies provided through this Agreement and to ensure the appropriate administration and delivery of services provided through this Agreement.